20181453 Ver 1_Shoreline Stabilization_20181024

State of North Carolina
Department of Environment and Natural Resources
DWR Division of Water Resources
15A NCAC 02H .0500 — Water Quality Certification, Shoreline Stabilization
Division of Water Resources FORM: SSGP 10-2013
Shoreline Stabilization Application Forrp 0 1 8 1 4 5 3
Three copies of the application (including attachments) and the application fee should seqtt
to: AI,ID
If sending via US Postal Service
Karen Higgins
DWR — 401 & Buffer Permitting Branch
1617 Mail Service Center
Raleigh, NC 27699-1617
Applicant Information [15A NCAC 02H .0502(x)]
1. Owner Information
Name: Scott Geer & Amy C Meier
Mailing Address: 242 Baretta Court
Roseland NJ 07068
D
(1(' l- 2 4 2018
DEQ -WA R RESORCES
401 & BUFFER PERMITTING
Telephone Number: 973-277-9157 Fax Number:
E-mail Address: [e-mail]
2. Agent/ Contact Person Information
A signed and dated copy of the Agent Authorization letter (a form can be downloaded here:
http•//www saw usace army mil/Portals/59/docs/regulatory/regdocs/Permits/SAMPLE AGENT AUTH
ORIZATION FORM.pdf) must be attached if the Agent has signed this application form.
Name:
Company Affiliation:
Mailing Address:
Telephone Number:
E-mail Address:
Person to receive the Certification Approval:
Fax Number:
II. Project Information [15A NCAC 02H .0502(a) & (b)]
1. Attach a vicinity map (i.e. street map) clearly showing the location of the property with
respect to local landmarks such as towns, rivers, and roads.
2. Provide a detailed site plan showing property boundaries and proposed locations of
vegetation clearing, structures (buildings, retaining walls, docks, impervious surfaces,
FORM: SSGP 10-2013 Page 1 of 3

etc.), rip rap, excavation or dredging below Full Pond/ Normal Water Level elevations,
and construction access corridors. You may use the diagram provided at the end of this
application form.
3. Attach a photograph of the shoreline/ buffer proposed to be stabilized. (Include a scale
of some sort- a yard stick, shovel handle, etc.)
4. Location of the property (where work is to be conducted)
County: Stanly. Nearest Town: Norwood
Subdivision name or site address (include phase/lot number):
Edgewater on Lake Tillery Phase 1 Lot ##12
Directions to site - please include road names and numbers, landmarks, etc.: —
From Highway 52 in Albemarle — Head to Norwood on Hwy 52. Turn left onto
Bowers Road and go to the stop sign Turn left onto Indian Mound Road. Then in app. 1
mile turn right onto Randalls Church Road Turn left into the Edgewater Development and
take the 15` right (Forest Lake Court) Property is on the right
Latitude (in decimal degrees) 35.271860 Longitude (decimal degrees) -80.099530
5. Describe the existing land use or condition of the site at the time of this application
(residential, undeveloped, etc.): Residential
6. Property size (acres): .59
7. Lake/ river/ ocean adjacent to property: Lake Tillery
8. Describe proposed work (include discussion as to how hardening of shoreline has been
avoided, or why it is necessary):
Proposing to build a new boathouse pier and seawall
9. Will work be conducted from land?® From water? ❑
10. Total amount of disturbance (including all excavation, backfill, rip rap, retaining walls, etc.)
below the normal pool lake level/ Normal Water Level in square feet or acres:
166' of shoreline x 10' below full pond in 1660 sq. ft.
11. Total amount of disturbance (including all clearing, back fill, excavation, rip rap, retaining
walls, etc.) above the normal pool lake level/ Normal Water Level and 50 feet land -ward in
square feet or acres: 166' of shoreline x 12' above full pond is 1992 sq. ft.
.12. Please describe the vegetation above the normal pool lake level/ Normal Water Level and
50 feet landward to be impacted (number of trees, for instance): Normal
Ow er/Agent's Signature NC 02H . 502 Date
Agent's signature is valid only if an a ' horization letter from the owner is provided.
FORM: SSGP 10-2013 Page 2 of 3

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